CY Yeung

Case 1 (Figure 1)

This 8-year-old girl was seen by a doctor 4 days ago for sharp right sided lower abdominal pain, for which some topical liniment was applied and panadol given. The doctor was unable to find a definitive cause for her problem. Two days later, she developed progressive skin lesions as shown in Figures 1a & b, although the mother claimed that she did not apply the liniment to her back.

(a) What is the most likely diagnosis?

(b) What could be a possible differential diagnosis?

Figure 1a.	Figure 1b.

Case 2 (Figure 2)

This 6-year-old boy had fever, sore throat and some vomiting x 2 days. He was treated with 3 medicines, including antibiotic, antipyretic and anti-emetic by his doctor. He was admitted to the hospital, because his head was tilted backwards and to his right and was showing facial grimaces as in Figure 2a. His eyes were upturned when open. He could answer questions, although he was unable to correct this posture. Figure 2b showed his usual self minutes after he had received treatment from the paediatric doctor.

(a) What was he most likely suffering from?

(b) What was the most likely treatment he received from the paediatric doctor?

Figure 2a.	Figure 2b.

Answer to "Clinical Quiz" on Page 269

N.B. The Editors invite contributions of illustrative clinical cases or materials to this section of the journal.